Saturday, June 29, 2013

Summer has finally arrived in Western New York on both the
calendar and how it feels outside. So now is a great time to review the
importance of keeping well hydrated. During the warm summer months we are often
outside gardening, bike riding, walking, and mowing. This increased activity
combined with perspiring can lead to dehydration unless you’re careful that
your input equals your output. With this in mind, many clients ask, “How much
water do I need to drink daily”? Apparently the conventional wisdom of drinking
eight glasses a day was only a guideline and not based on scientific evidence.
So I often tell people to take their weight (in pounds), divide it in half, and
drink that number in ounces. This too is just a guideline because the amount of
fluids a person needs daily is unique to them. According to nephrologist Steven
Guest, MD, “Fluid losses occur continuously, from skin evaporation, breathing,
urine, and stool, and these losses must be replaced daily for good health”. A
good rule of thumb is to look at the color of your urine. Is it dark yellow or
orange in color or does it have a strong smell? These may be signs you’re not
drinking enough. Urine should be a pale yellow to a clear color. If you are
thirsty, this is the most obvious sign you need to hydrate more. It is a good
practice to drink more water when you are not thirsty then to wait until you’re
thirsty. Dry skin is another sign of dehydration, as is pinching the skin on
your hand. If it takes more than a few seconds to return to normal, this is a
sign of dehydration. When exercising, the American College of Sports Medicine
guidelines recommend that “people drink about 17 ounces of fluid about two
hours before exercise. During exercise, they recommend people start drinking
fluids early, and drink them at regular intervals to replace fluids lost by
sweating”.

The role of water in the human body is vital to our
survival. We are anywhere from 55% to 78% water depending on our size, but a
rule of thumb is 2/3 of our body consists of water. In addition:

·The brain consists of 90% water

·Bone consists of 22% water

·Blood consists of 83% water

·Muscle consists of 75% water

Even more than dehydration though, drinking water has many
health benefits. Some of which include:

·Drinking water may help with headaches and
fatigue. Since the brain is 90% water, if you become dehydrated, the brain
can’t function as well and you may get a headache. In addition, hydrating may
help you be more alert and able to concentrate better.

·Water helps with maintain normal bowel function
and prevent constipation. If you don’t drink enough water then the colon will
pull water from your stools to help maintain hydration and you get constipated.

·Hydrating helps with muscle cramps and fatigued
muscles. “When muscle cells don’t have adequate fluids, they don’t work as well
and performance can suffer,” says Dr. Guest. Water helps keep muscles and
joints lubricated as well as giving them the electrolytes to function properly.

·Water helps to detoxify us. The main toxin in
our bodies is blood urea nitrogen. This toxin is excreted through our kidneys.
Water helps flush toxins and waste products through our kidneys and out of our
bodies.

·Drinking water helps you to lose weight. Often
times people mistake thirst for hunger. Also water flushes out the by-products
of fat breakdown. There are no calories in water either. The next time you are
hungry drink a glass of water prior to eating something.

You can increase your water intake by having a glass of
water with every snack and meal Think about keeping a bottle of water with you
in your bag or desk. In addition, try eating lots of fruit and vegetables
(about 20% of our fluid intake comes from food). If you don’t like the taste of
water add some lemon or a squirt of juice.

Remember, drinking a healthy amount of water is not only
healthy it is vital to your health, so drink up!

Monday, June 24, 2013

Teddy, my 11 year old Pembroke Welsh Corgi had been dying
for years, but we didn’t know from what.
For about four years, Teddy had symptoms that indicated he was ill with something but no test was ever
conclusive as to what it was. His coat was rough and he had mangy bald spots. He
had episodes of bloody explosive diarrhea. He was apathetic and had no interest
in his family nor chasing a ball. He had arthritis, yeast infections, and was
20% overweight. Every test you could have done, we did, and every disease my
vet could think of was ruled out. Teddy’s ill health was a real mystery.

By September of 2012, his diarrhea had exacerbated to the
point where he was incontinent and would stool over-night in the mud room
(where the dogs slept). This made Teddy even more dejected and depressed, so
much so that he wanted to spend all day and night outside. Being outside all
the time further isolated Teddy from the family and he became more and more
depressed and anti-social. I brought Teddy to a specialist in October who
ultra-sounded his bowel but couldn’t find cancer, an obstruction, or
diverticula. By November, Teddy was so sick I brought him back to his regular
vet (for what seemed like the 100th time) and finally we had an answer. Teddy was in kidney failure. Awful news,
but at least we had an answer to what was wrong with him. By this time, Teddy
was terribly dehydrated and was kept at the vets to be pumped up with IV fluids
until he was stable enough to come home. The plan was to keep Teddy alive until
the kids came home from college at winter break, so they could say good-bye to
their beloved pet.

When I came to visit Teddy on the second day of his
hospitalization, he looked so miserable and unhappy, I decided to take him
home. Teddy was dying, and I wanted him to die surrounded by his familiar
surroundings, not in a cage with bright lights and the non-stop barking of
other dogs. My vet wasn’t happy about his going home, but eventually consented
and I was given instructions, IVs, medications, and a special dog food for
renal failure.

When I got Teddy home, I began to think about the
progression of his “vague” disease which eventually culminated in kidney
failure. I’m a nutritionist and I educate people daily on eating healthy “real
food”. I had over the years thought about Teddy’s diet but, he was on the
finest prescription dog food (for arthritis), so my vet discouraged me from making
his food. Now I had nothing to lose. I spoke to my vet about a dogs nutritional
needs. She said they didn’t learn much in vet school about nutrition but warned
me to be cautious about too much phosphorus and protein due to his failing
kidneys. I googled home- made dog food as well as read some horror stories on
what dog food manufacturers use in commercial (and prescription) dog food, and
began to experiment.

Finally I found a recipe I liked, and mixed up a batch.
Because Teddy had been on so many antibiotics, I added a probiotic and a
powdered multi- vitamin. Teddy chowed it down but amazingly so did Fritz our 7
year old Maltese/Westie mix. Fritz never
ate. He was such a finicky eater, he only nibbled a little here and there. Within
a week, Teddy’s diarrhea was GONE! Over
the weeks and months, Teddy’s energy increased and he stopped limping
(arthritis), he lost weight, and his coat grew back shiny and glossy. I stopped
all his medications and IV’s. He now takes walks every day and is back to
chasing his ball. (Corgis love to chase balls). Although Teddy is 11 years old
he now acts like a puppy. Everyone who sees him can’t believe he’s the same
dog. I am so happy I finally listened to
my intuition that “good health begins with good food”, but so sorry it took me
so long to follow my own advice, “you are what you eat”!

Disclaimer: This
is Teddy’s story only. I am not a veterinarian nor is the intent of this story
to deliver any veterinarian advice nor to diagnose any disease.

Saturday, June 8, 2013

Barb Goshorn, RN
MSACN“The Nurse
Nutritionist”

With the growing obesity epidemic many people are turning to
artificial sweeteners to help decrease calories and lose weight, but are they a
good substitute? There’s mounting
evidence that “diet” sweeteners not only contribute to weight GAIN but they also
come with a myriad of potential health concerns. According to a study from the
University Of Texas Health Sciences Center Division Of Epidemiology those who consume
diet drinks regularly have a 200 percent increased risk of weight gain, a 36
percent risk of pre-diabetes or metabolic syndrome, and a 67 percent increased
risk of diabetes. These statistics are alarming because since the 1960’s diet
drink consumption has increased 400 percent.

Research from Purdue University, Investigative Behavior
Center, and published in a recent issue of Behavioral Neuroscience suggests
that artificial sweeteners actually contribute to OVEREATING. In this study, one group of rats was fed
yogurt sweetened with glucose while the other group was fed yogurt sweetened
with saccharin. The rest of their diet remained the same. The rats that had the saccharin sweetened
water put on more weight, and gained more body fat than the rats that were fed
the glucose water. Although the study
was done with saccharin, the authors stated they believed aspartame, sucralose,
and acesfulame K would have had similar results.

Results published in the June 2010 issue of the Yale Journal
of Biology and Medicine concluded that rather than helping with weight loss,
artificial sweeteners actually appear to cause weight gain. The researchers determined that artificial
sweeteners heightened the motivation to eat more while also increasing
appetite.

Metabolic Syndrome is considered one of the fastest growing
health epidemics in America today, with almost 2/3 of Americans at risk. A symptom of metabolic syndrome is the
development of a “spare tire” around the abdomen. The April 2009 issue of Diabetes Care found
that the daily consumption of diet soda significantly increased the risk of
developing a large waist circumference thus increasing the risk for metabolic
syndrome.

A widely used artificial sweetener in soft drinks, gums,
gelatins, and dessert mixes is aspartame which is 180 times sweeter than sugar.
This artificial sweetener is a combination of the two amino acids,
phenylalanine and aspartic acid plus methanol (wood alcohol). Phenylalanine and
aspartic acid are not harmful when eaten in natural, unprocessed food. But when they are chemically manipulated
problems can potentially occur. Side effects such as headaches, mental
confusion, dizziness and seizures have been reported after consuming aspartame.

Another type of artificial sweetener is the sugar
alcohols. These include xylitol,
sorbitol, and mannitol. Sugar alcohols are not calorie free but contain
approximately 2.6 calories per gram. A
problem often seen with sugar alcohols are they can cause bloating, abdominal
pain, and diarrhea. Sugar alcohols are often an ingredient in protein bars, ice
cream, gum, and even tooth paste.

Another artificial sweetener is sucralose or Splenda. Sucralose
is unrecognized as a food by the body and therefore goes through the gut
largely undigested. It is therefore considered
“calorie free”. Is sucralose safe? The truth is there are no long-term studies
of the side effects of sucralose in humans. The manufacturer’s own short-term
studies showed that very high doses of sucralose (far beyond what would be
expected in an ordinary diet) caused shrunken thymus glands, enlarged livers,
and kidney disorders in rodents. A more recent study also shows that sucralose
significantly decreases beneficial gut flora.
In the 11 years sucralose has been on the market no INDEPENDENT (not
paid for by the manufacturer) studies have been done on humans. Of the trials that were done, all were small
and for very short periods of time.
Remember saccharin and aspartame were once touted as the perfect sugar
substitutes too!

So if you are looking for a way to add some sweetness
without adding sugar or artificial sweeteners what can you use? One option may be stevia. Stevia is a relative of herbs and shrubs in
the sunflower family from Paraguay and Brazil and is approximately 200-300 times
sweeter than sugar. Stevia’s sweetness
actually comes from the leaves of the plant.
Another positive aspect of stevia is it does not raise the glucose
levels. Other natural alternatives include: agave nectar, date sugar, and
honey.

Saturday, June 1, 2013

Barb Goshorn RN MSACN

“The Nurse Nutritionist”

How long have we been
hearing this? Since the 1960’s, this is the foundation of our belief in what
causes obesity. If we take in more calories than we expend, we get fat. There
are many researchers who are no longer buying into this theory, though. One is
Dr. David Ludwig, of Boston Children’s Hospital and his collaborators. The
Journal of the American Medical Association recently published the results of
his research and instead of excess calories being implicated in the obesity
epidemic, the hormone insulin appears to be the culprit.

Until the 1960’s,
carbohydrates were indeed considered a likely suspect in obesity. “Every woman
knows that carbohydrate is fattening” as two British Dieticians began a 1963
British Journal of Nutrition article. Carbohydrates stimulate the secretion of the
hormone insulin, which works, among other things, to store fats in our fat
cells. In 1921, insulin was discovered and nicknamed, “The fat storage
hormone”. For a number of reasons though, conventional wisdom shifted and
obesity became an energy imbalance issue. Carbohydrates, with less than half
the calories per gram of fat, became the heart-healthy diet food. With this
transformation, fat was removed from foods and we were told to eat low-fat,
carbohydrate-rich foods that would keep us thin.

Unfortunately, this theory
hasn’t seemed to work. Each decade the obesity epidemic grows exponentially. It
may be time to look at an alternate theory as to why we get fat. Dr. Ludwig and
his team concluded that it was the nutrient composition of the diet that
triggered weight gain independent of calories consumed. The fewer carbohydrates
eaten (simple versus complex), the less weight gained and the more carbohydrates
eaten, the more weight the subjects gained. It was concluded, that the
carbohydrates were fattening, and obesity triggered by elevations in insulin,
triggered fat storage.

This is the polar opposite
of what we have been told to eat for decades: eat a low-fat, carbohydrate-rich
diet. The results and conclusion are naturally very controversial. Yet what we
have been educating people to eat obviously hasn’t been working. I know from a
clinical perspective, my clients are most successful when their carbohydrate
intake is from vegetables and fruit with a minimum of grains. Instead of
counting calories, think about eating to avoid huge spikes in insulin.